JP7162943B1 - Information processing apparatus for epilepsy diagnosis, information processing method for epilepsy diagnosis, and computer program for epilepsy diagnosis - Google Patents

Abstract

A technique for appropriately sensing electrical activity of brain tissue in epilepsy diagnosis is provided. Kind Code: A1 An information processing apparatus for epilepsy diagnosis includes reception means for accepting designation of a first location, which is a target for detection of an electrical signal, in brain tissue of a subject, and an epilepsy diagnosis device arranged in a blood vessel. , intravascular delivery performance, size, expansion force, effective length, diameter, diameter of a catheter suitable for combined use, wire information receiving means for receiving wire information including at least one, and in or near the brain tissue of the subject Identifying means for identifying a second location or region of a blood vessel in which the device can be placed and which is suitable for detecting an electrical signal from the first location by the device, based on the wire information. and display control means for displaying the second location in the blood vessel on a predetermined display unit. [Selection] Figure 4 TIFF0007162943000002.tif221163

Description

The present invention relates to an information processing apparatus for epilepsy diagnosis, an information processing method for epilepsy diagnosis, and a computer program for epilepsy diagnosis .

Surgery for intractable epilepsy (epilepsy in which seizure symptoms cannot be relieved by drugs) is performed by surgically removing a part of the brain tissue. Various methods have been used to identify the site to be resected, but each method has many problems.
For example, electroencephalograms are measured using electrodes attached to the scalp. Such electroencephalogram measurement is non-invasive and can be performed in many facilities, but it has low spatial resolution and temporal resolution, and there is a possibility that the site to be excised cannot be correctly identified.

Also, for example, electroencephalograms are measured by attaching subdural electrodes or inserting deep electroencephalogram electrodes after craniotomy. Although such electroencephalogram measurement has high spatial resolution and temporal resolution, it is extremely invasive, and there is a possibility that complications may occur due to intracranial electrodes as described above. In addition, there are problems such as the indwelling of intracranial electrodes as described above for a long period of time due to the condition of the brain surface, and the limited number of neurosurgery specialists, which limits the number of facilities that can perform such operations.

In recent years, a technique has been disclosed in which an electrode is provided in a blood vessel and electrical activity of nerve tissue is sensed in the blood vessel by the electrode. Patent Literature 1 discloses a technique for sensing electrical activity of nearby nerve tissue by expanding a stent provided with electrodes inside a cerebral blood vessel and anchoring it to the blood vessel wall.

JP 2017-159079 A

Here, in identifying the epileptic focus or detecting an epileptic seizure, the problem is at which position in the blood vessel the signal of the designated brain tissue should be received.

SUMMARY OF THE INVENTION The present invention has been made in view of such circumstances, and an object of the present invention is to provide a technique for appropriately sensing electrical activity of brain tissue in diagnosing epilepsy.

In order to achieve the above object, one aspect of the present invention is
receiving means for receiving designation of a first location, which is a target for detection of electrical signals, in brain tissue of a subject;
Wire information reception for receiving wire information including at least one of intravascular delivery performance, size, expansion force, effective length, diameter, diameter of catheter suitable for combined use in an epilepsy diagnosis device placed in blood vessels means and
Among blood vessels in or near the brain tissue of the subject, based on the wire information, a position or region of a blood vessel to which the device can be placed, and which is suitable for detection of an electrical signal from the first location by the device. identifying means for identifying the second location;
display control means for displaying the second location in the blood vessel on a predetermined display unit;
It is an information processing device for epilepsy diagnosis having

INDUSTRIAL APPLICABILITY According to the present invention, it is possible to provide a technique for appropriately sensing electrical activity of brain tissue in epilepsy diagnosis.

FIG. 4 is a diagram showing an overview of image display; It is a figure which shows the outline of a structure of a system. It is a block diagram which shows the hardware constitutions of a server. It is a functional block diagram which shows an example of the functional structure of a server. 4 is a flowchart showing an example of the operation of image display processing; It is a figure which shows an example of a correspondence table. 4 is a flowchart showing an example of the operation of image display processing; 4 is a flowchart showing an example of the operation of electroencephalogram analysis processing; FIG. 1 shows blood vessels in the brain.

(embodiment)
<Overview>
Hereinafter, this embodiment will be described with reference to the drawings. FIG. 1 is a diagram showing an overview of image display to which a server 1 (information processing device) according to this embodiment is applied.

In the example of FIG. 1, the server 1 acquires various images from the image acquisition device IM.
The image acquisition device IM is a device that acquires an image showing in vivo information of a patient PT (subject; organism such as an animal or a human being). More specifically, the image acquisition device IM obtains, as in vivo information, an image (first image) showing a living tissue that generates electrical signals, and a blood vessel image (second image) showing blood vessels in or near the living tissue. ).
The biological tissue includes nerves (nerve tissue) such as the brain, muscles (muscle tissue) such as the heart, etc. In this embodiment, brain tissue will be described as an example of the biological tissue. That is, the server 1 acquires a brain tissue image BI (first image) and a blood vessel image VI (second image) representing the brain tissue of the patient PT from the image acquisition device IM.

The brain tissue image BI is, for example, an image of brain tissue acquired using MRI (Magnetite Resonance Imaging). Specifically, the brain tissue image BI is an image obtained by capturing a tomographic image of brain tissue using the nuclear magnetic resonance phenomenon, and is the tomographic image or a three-dimensional image based thereon. With the brain tissue image BI, the target brain tissue can be viewed from various angles. The doctor DC can grasp the shape and size of the brain tissue, the state of the brain tissue (for example, the presence or absence of a tumor), etc. from the brain tissue image BI.

The blood vessel image VI is, for example, a magnetic resonance angiography (MRA) acquired using the MRI described above. In the blood vessel image VI, target blood vessels (running blood vessels) can be viewed from various angles. The doctor DC can grasp the course of the blood vessels in the head, the thickness of the blood vessels, the condition of the blood vessels (for example, the presence or absence of a tumor), and the like from the blood vessel image VI.

The server 1 displays the acquired brain tissue image BI and blood vessel image VI on the terminal 2 of the doctor DC (the display unit of the terminal 2; a predetermined display unit). In this embodiment, the server 1 performs two types of display according to the setting of the position designation mode (predetermined mode).
For example, when the position specification mode is ON, the server 1 displays the brain tissue image BI and the blood vessel image VI side by side on the terminal 2 . At this time, the server 1 accepts designation of a site (hereinafter referred to as a first site DP) that is a target for detection of electrical signals in the brain tissue. Then, the server 1 selects a location ( hereinafter referred to as a second point CP). Furthermore, the server 1 displays the identified second location CP on the terminal 2 .
Further, for example, the server 1 associates the brain tissue image BI with the blood vessel image VI when the position specification mode is OFF. Then, the server 1 superimposes (synthesizes) the brain tissue image BI and the blood vessel image VI and displays them on the terminal 2 as a synthesized image FI (third image). A method of associating the brain tissue image BI and the blood vessel image VI will be described later.

The doctor DC refers to the brain tissue image BI and the blood vessel image VI displayed on the terminal 2 or the composite image FI to determine the position (intravascular position) to place the intravascular device (not shown; epilepsy diagnostic device). ). Then, the doctor DC delivers the intravascular device into the cerebral blood vessels of the patient PT while being inserted into a catheter used for conventional cerebral endovascular surgery. At this time, as shown in FIG. 1, the doctor DC displays an angiographic image AI (real-time image; fourth image) obtained by angiography AM (angiography) on the display unit of the terminal 2 or another display device (for example, , the angiographic image AI is displayed on the external display device 3) of FIG. Specifically, the doctor DC places an intravascular device at the second location CP displayed on the terminal 2, and uses the indwelling intravascular device to detect electrical signals from the first location DP. In addition, the intravascular device to be inserted may be singular or plural.
Note that the angio image AI is an image showing the position of the intravascular device along with the course of blood vessels. For example, in the angio image AI of FIG. 1, the position indicated by symbol VD indicates the current position (for example, the position of the tip) of the intravascular device in the blood vessel. By viewing both the above-described angio image AI (fourth image) and the above-described composite image FI (third image), the doctor DC can easily deliver the intravascular device to the second location correctly.
The brain tissue image BI, blood vessel image VI, composite image FI, and angio image AI may be arbitrarily associated with each other, and may or may not be associated.
The angio image AI may be displayed alone, or may be displayed side by side with at least one or more of the brain tissue image BI, blood vessel image VI, and composite image FI.

Intravascular devices are inserted into cerebral blood vessels through catheters used for cerebral endovascular surgery. The intravascular device comprises at least one electrode positioned within a blood vessel of a living organism for sensing activity in nearby extravascular body tissue. An intravascular device can stably measure an electroencephalogram by being fixed at a predetermined position within a blood vessel. In addition, since intravascular devices are inserted into extremely thin blood vessels, identification of the indwelling position within the tissue is clinically important.

In the intravascular device, the electrodes may be provided on a wire member. In this case, the expansion force is smaller than that of the stent, and the slidability against the catheter is excellent. Excellent in nature. In addition, the contact of the wire member with the blood vessel is suppressed (especially, the wire member, which is rod-shaped in its natural state, hardly contacts the blood vessel wall), so it is preferable in that adverse events are unlikely to occur even if it is indwelled for a long time. . Therefore, it is preferable to leave it in the blood vessel for one day or more.
An intravascular device includes a core and an insulator. More specifically, the outer circumference of the core material may be covered with an insulator.
As the core material, for example, an ultrafine wire made of stainless steel or nickel-titanium alloy may be used.
Examples of insulators include polyimide tubes and PTFE tubes. In addition, although the insulator itself is a cylindrical body, since the inner side thereof is filled with a core material, it can be regarded as a wire member as an intravascular device.

The intravascular device may also include an intravascular electrode and a preliminary intravascular electrode, which are slightly spaced from each other and on the same wire member. Note that the number of electrodes provided in one intravascular device is not limited to this, and may be one or three or more.
By using such a thin intravascular device with no expansion force, it is easy to carry the intravascular device to the vicinity of the first location even in the peripheral portion of the blood vessel. In other words, this type of intravascular device has a high degree of freedom in the intravascular installation site, so there is a strong need to perform the delivery operation while grasping the second site. This is in contrast to stent-type intravascular devices, which are naturally constrained in their intravascular placement location due to their inherent size and expansion forces.

In addition, the intravascular device may have a portion composed of an X-ray opaque member (for example, platinum). As a result, the position of the intravascular device within the blood vessel can be grasped in real time like the angio image AI (fourth image) described above.
The server 1 acquires the potential information obtained from the intravascular electrodes (via the intravascular device and the terminal 2) and calculates the electroencephalogram measurement results (electroencephalogram analysis).

Physician DC identifies the site to be resected (for example, tumor) based on the electroencephalogram measurement results. Physician DC then performs a surgical operation to remove a portion of the identified brain tissue.
Image display and electroencephalogram analysis will be described in detail below.

<System configuration>
FIG. 2 is a diagram showing an outline of the configuration of the system according to this embodiment. The system according to this embodiment is configured by connecting a server 1 that performs processing, a terminal 2, and an image acquisition device IM to each other via a predetermined network N such as the Internet. Terminal 2 and an intravascular device are also connected.

The server 1 cooperates with each operation of the terminal 2 and the image acquisition device IM to execute various processes. The terminal 2 displays the chart of the patient PT.

<Hardware configuration>
FIG. 3 is a block diagram showing the hardware configuration of the server 1 according to this embodiment. The server 1 includes a CPU (Central Processing Unit) 11, a ROM (Read Only Memory) 12, a RAM (Random Access Memory) 13, a bus 14, an input/output interface 15, an output section 16, and an input section 17. , a storage unit 18 , a communication unit 19 , and a drive 20 .

The CPU 11 executes various processes according to programs recorded in the ROM 12 or programs loaded from the storage unit 18 to the RAM 13 . The RAM 13 also stores data necessary for the CPU 11 to execute various processes. The CPU 11 , ROM 12 and RAM 13 are interconnected via a bus 14 . An input/output interface 15 is also connected to this bus 14 .

An output unit 16 , an input unit 17 , a storage unit 18 , a communication unit 19 and a drive 20 are connected to the input/output interface 15 . The output unit 16 includes a display, a speaker, and the like, and outputs various information as images and sounds. The input unit 17 is composed of a keyboard, a mouse, etc., and inputs various kinds of information. The storage unit 18 is composed of a hard disk, a DRAM (Dynamic Random Access Memory), or the like, and stores various data. The communication unit 19 communicates with other devices via a network N including the Internet.

A removable medium 21 such as a magnetic disk, an optical disk, a magneto-optical disk, or a semiconductor memory is mounted in the drive 20 as appropriate. A program read from the removable medium 21 by the drive 20 is installed in the storage section 18 as necessary. In addition, the removable medium 21 can also store various data stored in the storage section 18 in the same manner as the storage section 18 .

Although not shown, the terminal 2 has the hardware configuration shown in FIG.

<Functional configuration>
FIG. 4 is a functional block diagram showing an example of the functional configuration of the server 1 according to this embodiment.

In the CPU 11 of the server 1, an image acquisition unit 31, a designation reception unit 32, a position identification unit 33, a correspondence unit 34, an electroencephalogram acquisition unit 35, an electroencephalogram analysis unit 36, and a display control unit 37 function during operation. Further, in the storage unit 18 of the server 1, an image DB 41 and an electroencephalogram information DB 42 are provided.

The image acquisition unit 31 acquires the brain tissue image BI and blood vessel image VI of the patient PT acquired by the image acquisition device IM. Various image information acquired by the image acquisition unit 31 is stored in the image DB 41 .

The designation receiving unit 32 (receiving means) receives designation of the first part DP in the brain tissue image BI from the doctor DC.
In this embodiment, the designation receiving unit 32 receives designation of the first part DP by the doctor DC while the brain tissue image BI is being displayed on the terminal 2 .
The first point DP can also be regarded as a part of brain tissue (for example, temporal lobe, hippocampus, amygdaloid nucleus, cortical tubercle, etc.) for which the doctor DC wants to measure the electroencephalogram.
The method of specifying the first location DP is not particularly limited. For example, the designation receiving unit 32 accepts the designation of the first location DP by receiving the selection of the site in the brain tissue from the doctor DC instead of the image. good too. In this case, a correspondence table (FIG. 6A or FIG. 6B) that associates the position (or site or region) of the brain tissue with the position (site or region) of the blood vessel is prepared in advance in the storage unit 18, and will be described later. The position specifying unit 33 may specify a second point CP, which will be described later, by referring to the correspondence table.

The position specifying unit 33 (specifying means) specifies the second location CP corresponding to the above-described first location DP in the blood vessel image VI.
Here, the first point DP is a point in the brain tissue, and the second point CP is a point in the blood vessel (running) corresponding to the first point DP. The second point CP is desirably a point on the running blood vessel that has the shortest distance (for example, Euclidean distance) from the first point DP in the brain tissue. This is because the electroencephalogram at the first point DP can be acquired more accurately at the second point CP in the blood vessel.
Note that the identification method is not particularly limited, and various methods can be applied.
For example, the position specifying unit 33 may specify the second point CP corresponding to the first point DP using the above-described association table.
Further, for example, when the brain tissue image BI and the blood vessel image VI are three-dimensional images, the position specifying unit 33 determines the positions of the brain tissue image BI and the blood vessel image VI based on the respective centroid positions and cross-sectional directions. After matching the relationship, the second point CP corresponding to the above-described first point DP may be specified.
Further, for example, when the synthetic image FI is manually synthesized by the doctor DC or the like, the synthetic image FI may be used to identify the second location CP corresponding to the above-described first location DP.

Note that the position identifying unit 33 may identify the second location CP based on information on the intravascular device (device).
The information on the intravascular device includes, for example, information on the intravascular delivery performance of the intravascular device, information on the size and/or expansion force of the intravascular device, and the like.
In the case of a wire, for example, the information of the intravascular device (wire information) includes the effective length, the diameter (when released), the diameter of the catheter suitable for combined use (interpolation), and the like.
For example, the position specifying unit 33 obtains positions where the intravascular device can be placed according to the intravascular delivery performance, size, and expansion force of the intravascular device. Specifically, the position specifying unit 33 determines the position and region of the blood vessel where the intravascular device can be placed (for example, a blood vessel with a larger diameter than the superior sagittal sinus) according to the size of the intravascular device. Ask. Then, the position specifying unit 33 specifies, as the second point CP, the place where the blood vessel runs the shortest distance from the first point DP in the arrangeable blood vessel.
Here, the intravascular delivery performance is an index showing slidability with respect to a catheter. The higher the slidability, the better the intravascular delivery performance.
In addition, expandability is an index showing expansion force in blood vessels. In order to sense the electrical activity of nearby nerve tissue by expanding an intravascular device provided with electrodes in a cerebral blood vessel and anchoring it to the blood vessel wall, for example, when using a highly expandable intravascular device , the diameter of the blood vessel to which the intravascular device is locked must also be large (thick) to some extent.
The method of acquiring the information of the intravascular device is not particularly limited. For example, the information of the intravascular device may be received by a receiving unit (device receiving means) (not shown), and stored in the storage unit 18 in advance. It may be obtained from a DB or the like.

The associating unit 34 associates the brain tissue image BI with the blood vessel image VI. For example, when the brain tissue image BI and the blood vessel image VI are three-dimensional images, the associating unit 34 determines the positional relationship between the brain tissue image BI and the blood vessel image VI based on the position of the center of gravity and the cross-sectional direction of each. may be associated. Note that the association unit 34 may associate the brain tissue image BI and the blood vessel image VI to generate the composite image FI.

The electroencephalogram acquisition unit 35 acquires electroencephalograms from an intravascular device inserted into the brain blood vessels of the patient PT by the doctor DC. Specifically, the electroencephalogram acquisition unit 35 acquires potential information obtained from intravascular electrodes in the intravascular device. The acquired electroencephalograms are stored in the electroencephalogram information DB 42 .

The electroencephalogram analysis unit 36 analyzes the electroencephalograms acquired by the electroencephalogram acquisition unit 35 . For example, the electroencephalogram analysis unit 36 performs Fourier transform or the like on the electroencephalogram described above to generate information for the doctor DC to make a diagnosis.

The display control unit 37 (display control means) displays various information on the terminal 2 .
For example, the display control unit 37 displays the brain tissue image BI and the blood vessel image VI on the terminal 2 . Then, the display control unit 37 displays on the terminal 2 an item indicating the first point DP in the brain tissue image BI and the second point CP in the blood vessel image VI. Here, the item is an icon such as a dot or a frame that indicates the first point DP or the second point CP. Note that the display control unit 37 may display an item indicating the blood vessel image VI (second image) and the second part CP on the terminal 2 without displaying the brain tissue image BI (first image).
Also, for example, the display control unit 37 displays the analysis result analyzed by the electroencephalogram analysis unit 36 on the terminal 2 .

<Processing content: Image display processing>
FIG. 5 is a diagram showing an example of image display processing according to this embodiment. In FIG. 5, the server 1 acquires the brain tissue image BI and the blood vessel image VI from the image acquisition device IM, and displays them on the terminal 2 . FIG. 5 shows image display processing when the position designation mode is ON, for example.

In step S<b>1 , the image acquisition unit 31 acquires the brain tissue image BI acquired by the image acquisition device IM, and stores it in the image DB 41 . The brain tissue image BI is, for example, an image of brain tissue acquired using MRI.

In step S<b>2 , the image acquisition unit 31 acquires the blood vessel image VI acquired by the image acquisition device IM, and stores it in the image DB 41 . The blood vessel image VI is, for example, a magnetic resonance angiogram (MRA) acquired using the MRI described above.

In step S3, the designation receiving unit 32 receives designation of the first part DP in the brain tissue image BI. For example, the designation receiving unit 32 receives the designation of the first location DP when the doctor DC selects a portion of the brain tissue image BI or selects a portion of the brain tissue.

In step S4, the position specifying unit 33 specifies the position of the second point CP in the blood vessel image VI corresponding to the first point DP in the brain tissue image BI designated in step S4, as described above.

The position specifying unit 33 specifies the second point CP using, for example, the correspondence table shown in FIG. 6A. The correspondence table shown in FIG. 6A is stored in advance in the storage unit 18, for example.
FIG. 6A shows an example of a correspondence table in this embodiment. In the association table shown in FIG. 6A, the first location in the brain tissue is associated with the second location in the blood vessel corresponding to the first location.
For example, when the designation receiving unit 32 receives “brain tissue xxx”, which is a part of brain tissue, as the first location DP, the position specifying unit 33 refers to FIG. The “intravascular location aaa”, which is the location in the blood vessel where the blood vessel is located, is specified as the second location CP.
Further, when the information on the intravascular device is acquired as described above, the position specifying unit 33 may specify the second location CP using, for example, the correspondence table shown in FIG. 6B. The correspondence table shown in FIG. 6B is stored in advance in the storage unit 18, for example.
FIG. 6B shows an example of a correspondence table in this embodiment. In the association table shown in FIG. 6B, a first location in the brain tissue is associated with one or more second locations in the blood vessel corresponding to the first location.
For example, when the designation accepting unit 32 accepts “brain tissue xxx”, which is a part of brain tissue, as the first location DP, and information on the intravascular device (for example, size, expandability, etc.) is acquired, 6B, the position specifying unit 33 acquires “intravascular location ppp”, “intravascular location qqq”, and “intravascular location rrr”, which are locations in the blood vessel corresponding to “brain tissue xxx”. . Then, the position specifying unit 33 specifies a place where the intravascular device can be placed among the “intravascular site ppp”, “intravascular site qqq”, and “intravascular site rrr”. At this time, in the correspondence table, it is preferable that the blood vessel diameter and information on the distance from the corresponding brain tissue are recorded in association with the intravascular location. As a result, the position specifying unit 33, for example, considers the diameter of the blood vessel and the size of the intravascular device, and selects the position closest to the corresponding tissue among the positions where the intravascular device can be placed as the second position. Can be identified as a CP.
Note that the position specifying unit 33 is not limited to the table described above. For example, when the first part DP and the information of the intravascular device (size, expandability, etc.) are input, the position specifying unit 33 outputs a predetermined function that outputs the second part CP. may be used to identify the second location CP.

In step S<b>5 , the display control unit 37 displays the brain tissue image BI and the blood vessel image VI side by side on the terminal 2 . In the present embodiment, displaying the brain tissue image BI and the blood vessel image VI side by side means displaying the brain tissue image BI and the blood vessel image VI in one display unit or dividing them into a plurality of display units so that they do not overlap, or displaying the brain tissue image BI and the blood vessel image VI separately. It includes displaying on the display unit so as to partially or wholly overlap with the blood vessel image VI. Partial overlap of the brain tissue image BI and the blood vessel image VI includes, for example, displaying a reduced blood vessel image VI at the edge of the brain tissue image BI. To completely overlap the brain tissue image BI and the blood vessel image VI includes adjusting the transparency of one or both of the images and displaying them in an overlapping manner.
Further, when the brain tissue image BI and the blood vessel image VI are displayed side by side, the display control unit 37 changes the display angle and display mode (for example, cross-sectional 2D display mode, 3D display mode, etc.) of one of the images. In this case, the display angle and display mode of the other image may be changed following (interlocking).
Note that the display control unit 37 may display the composite image described above on the display unit of the terminal 2 .

In step S6, the display control unit 37 displays an item indicating the second location CP on the blood vessel image VI. Note that the display control unit 37 may display an item indicating the first part DP on the brain tissue image BI.

FIG. 7 is a diagram showing an example of image display processing according to this embodiment. In FIG. 6, the server 1 acquires the brain tissue image BI and the blood vessel image VI from the image acquisition device IM, and displays them on the terminal 2 . FIG. 6 shows image display processing when the position specification mode is OFF, for example.

Since steps S11 and S12 are the same as steps S1 and S2 described above, descriptions thereof will be omitted.

In step S13, the associating unit 34 associates the brain tissue image BI and the blood vessel image VI as described above. The associating unit 34 also generates a synthesized image FI by synthesizing the brain tissue image BI and the blood vessel image VI that have been associated with each other. As described above, when the brain tissue image BI and the blood vessel image VI are three-dimensional images, the associating unit 34, for example, based on the position of the center of gravity and the cross-sectional direction of each of the brain tissue image BI and the blood vessel image. The positional relationship of VIs may be associated.
Note that the associating unit 34 may manually acquire a synthesized image FI obtained by synthesizing the brain tissue image BI and the blood vessel image VI manually by a person such as a doctor DC. As for the method of generating the composite image FI, for example, the doctor DC acquires brain tissue data and blood vessel data by MRI. Then, the doctor DC uses predetermined software to superimpose the brain tissue data and the blood vessel data to generate a composite image FI.
Note that, for example, when the brain tissue image BI and the blood vessel image VI are synthesized by an apparatus such as MRI, the associating unit 34 may acquire the synthetic image FI synthesized from the MRI or the like.

In step S<b>14 , the display control unit 37 displays on the terminal 2 a synthesized image FI obtained by synthesizing the brain tissue image BI and the blood vessel image VI.

<Processing content: electroencephalogram analysis processing>
FIG. 8 is a diagram showing an example of image display processing according to the present embodiment. In FIG. 8, the server 1 acquires electroencephalograms from the intravascular device and displays the result of electroencephalogram analysis on the terminal 2 .
Specifically, in step S<b>21 , the electroencephalogram acquisition unit 35 acquires electroencephalograms (electroencephalogram signals) from the intravascular electrodes and stores them in the electroencephalogram information DB 42 .
Then, in step S22, the electroencephalogram analysis unit 36 analyzes the obtained electroencephalogram.
Furthermore, in step S<b>23 , the display control unit 37 displays the analysis result on the terminal 2 .

<Vessel running in brain blood vessels>
FIG. 9 is a diagram showing an example of blood vessel running in intracerebral blood vessels.
For example, with an intravascular device as thin as 0.25 mm, an intravascular electrode can be placed in a peripheral portion (thin portion) of the blood vessel. For example, it is assumed that the intravascular electrodes described above are placed in the locations (areas) indicated by black circles in FIG.
For example, the second point CP may be a position in the blood vessel upstream of the superior sagittal sinus. Here, the upstream side of the superior sagittal sinus refers to a blood vessel that is narrower than the superior sagittal sinus and located upstream of the blood flow.
Also, for example, the second point CP may be a position in a blood vessel having an inner diameter of 1 mm or more and 10 mm or less. The inner diameter of the blood vessel may be the diameter if the blood vessel is circular, or the inner diameter at the largest point if the blood vessel is elliptical. Note that 1 mm and 10 mm are examples, and the position in the blood vessel whose inner diameter is within a predetermined range may be used.
Also, the second point CP may be a position in the blood vessel within a predetermined area (for example, the area indicated by the black circle in FIG. 9).

<Advantageous effects of the present embodiment>
According to the above-described embodiments, for example, if the intravascular device of the present invention is appropriately placed in a cerebral blood vessel near each of the left brain and the right brain and electroencephalograms are detected, epileptic foci can be identified and epileptic seizures can be detected. Can be used for detection. To properly sense the electrical activity of living tissue that generates electrical signals by correlating brain tissue with blood vessels to indicate a second location in the blood vessel that corresponds to the first location in the brain tissue. A doctor can easily grasp the place where the intravascular electrode is to be arranged.
Further, according to the above-described embodiment, by displaying a composite image of a brain tissue image and a blood vessel image, an intravascular electrode can be placed in order to appropriately sense the electrical activity of living tissue that generates an electrical signal. The location can be easily grasped by a doctor.
As a result, the spatial resolution and the temporal resolution can be increased in the measurement of electroencephalograms at the first location in the brain tissue.
In addition, since the intravascular electrode can be left in the blood vessel for a longer period of time than the intracranial electrode, the electroencephalogram can be continuously measured.
In addition, as a result, even if you are not a specialist in neurosurgery, you only need a doctor who can perform endovascular surgery. will increase.

Further, according to the above-described embodiment, by performing analysis processing on the electroencephalogram obtained from the intravascular electrode, it is possible to grasp the state of the electroencephalogram in real time.

In addition, according to the above-described embodiment, by indicating the thin part of the blood vessel as the second part, it is difficult to reach with the conventional intravascular device, but for example, it is thin (about 0.25 mm) and has a dilating force. If an intravascular device with a small diameter is used, an intravascular electrode can be placed in an accessible peripheral area, making various diagnoses possible.
Since such intravascular devices are much less invasive than intracranial electrodes, side effects and complications associated with using such intravascular devices are less likely.
In addition, while intracranial electrodes measure only brain surface potentials, the intravascular device described above is capable of obtaining potentials deep in the brain, enabling monitoring of a wider range of brain regions.
Furthermore, intracranial electrodes require a craniotomy, limiting the area that can be applied. On the other hand, the intravascular devices described above can be easily placed even in very distant areas, such as the forehead and the back of the head.

Although one embodiment of the present invention has been described above, the present invention is not limited to the above-described embodiment, and modifications, improvements, etc. within the range that can achieve the object of the present invention are included in the present invention. is.

(Modification)
In the above-described embodiment, an example of displaying a brain tissue image and a blood vessel image in a surgical examination for intractable epilepsy has been described. Images may be displayed.

In the above-described embodiment, an example in which a brain tissue image and a blood vessel image are displayed side by side or a composite image is displayed according to the mode (position specifying mode) has been described, but the present invention is not limited to this.
For example, based on the information indicating the second location and the angiographic image information, when one or more of the fact that the intravascular device approaches, reaches, or passes the second location is detected, the detection is notified in real time. (display).
Alternatively, for example, a brain tissue image and a blood vessel image may be displayed without providing a mode.
Also, for example, a composite image may be displayed without providing a mode. Also, for example, a brain tissue image, a blood vessel image, and a composite image may be displayed side by side.

In the above embodiment, an example of obtaining a brain tissue image using MRI was described, but the present invention is not limited to this. A brain tissue image may be obtained using CT (Computed Tomography) or MEG (Magneto Encephalo Graphy).

In the above-described embodiments, MRA is used as the blood vessel image, but the method of acquiring the blood vessel image is not particularly limited, and may be acquired by various methods.

In the above-described embodiments, an example of sensing an electrical signal of a living tissue (measurement of an electroencephalogram) from an intravascular electrode has been described, but the present invention is not limited to this, and an intravascular electrode may be used for various purposes.

Also, for example, the series of processes described above can be executed by hardware or by software. In other words, the functional configuration described above is merely an example and is not particularly limited. That is, it is sufficient that the above-described system has a function capable of executing the above-described series of processes as a whole, and what kind of functional block is used to realize this function is not particularly limited to the above example. Also, the locations of the functional blocks are not particularly limited to those shown in FIG. 4, and may be arbitrary. For example, the functional blocks of the server may be transferred to another device or the like. Conversely, functional blocks of other devices may be transferred to a server or the like. Also, one functional block may be composed of hardware alone, software alone, or a combination thereof.

When a series of processes is to be executed by software, a program constituting the software is installed in a computer or the like from a network or a recording medium. The computer may be a computer built into dedicated hardware. Also, the computer may be a computer capable of executing various functions by installing various programs, such as a server, a general-purpose smart phone, or a personal computer.

A recording medium containing such a program not only consists of a removable medium (not shown) that is distributed separately from the device main body in order to provide the program to the user, etc., but is also preinstalled in the device main body and stored in the user's memory. It is composed of a recording medium etc. provided for

In this specification, the steps of writing a program recorded on a recording medium are not necessarily processed chronologically according to the order, but may be executed in parallel or individually. It also includes the processing to be performed. Further, in this specification, the term "system" means an overall device composed of a plurality of devices, a plurality of means, or the like.

1: Server 2: Terminal 11: CPU
18: Storage Unit 19: Communication Unit 31: Image Acquisition Unit 32: Designation Acceptance Unit 33: Position Specification Unit 34: Association Unit 35: Electroencephalogram Acquisition Unit 36: Electroencephalogram Analysis Unit 37: Display Control Unit

Claims (11)

receiving means for receiving designation of a first location, which is a target for detection of electrical signals, in brain tissue of a subject;
Wire information reception for receiving wire information including at least one of intravascular delivery performance, size, expansion force, effective length, diameter, diameter of catheter suitable for combined use in an epilepsy diagnosis device placed in blood vessels means and
Among blood vessels in or near the brain tissue of the subject, based on the wire information, a position or region of a blood vessel to which the device can be placed, and which is suitable for detection of an electrical signal from the first location by the device. identifying means for identifying the second location;
display control means for displaying the second location in the blood vessel on a predetermined display unit;
An information processing device for epilepsy diagnosis. further comprising device reception means for receiving information on the device;
The identifying means identifies the second location based on information of the device.
The information processing apparatus for epilepsy diagnosis according to claim 1. The device information includes information related to intravascular delivery performance of the device.
The information processing apparatus for epilepsy diagnosis according to claim 2. The device information includes information related to the size and/or expandability of the device,
4. The information processing apparatus for epilepsy diagnosis according to claim 2 or 3. The second location is a position in the blood vessel on the upstream side of blood flow from the superior sagittal sinus,
The information processing apparatus for epilepsy diagnosis according to any one of claims 1 to 4. The second location is a position in the blood vessel where the inner diameter of the blood vessel is 1 mm or more and 10 mm or less.
The information processing apparatus for epilepsy diagnosis according to any one of claims 1 to 5. The display control means displays a first image showing the brain tissue and a second image showing the blood vessel side by side on the display unit.
The information processing apparatus for epilepsy diagnosis according to any one of claims 1 to 6. The display control means displays, on a predetermined display unit , a fourth image obtained by an angiographic examination in addition to the first image and the second image.
The information processing apparatus for epilepsy diagnosis according to claim 7. 1. A wire-type intravascular device for placement in a blood vessel of an organism and comprising at least one electrode for sensing activity in nearby extravascular brain tissue, comprising:
Placed at the second location displayed by the information processing device for epilepsy diagnosis according to any one of claims 1 to 8, and used to detect an electrical signal from the first location,
Intravascular device. the computer
a receiving step of receiving designation of a first location, which is a target for detection of electrical signals, in brain tissue of a subject;
Wire information reception for receiving wire information including at least one of intravascular delivery performance, size, expansion force, effective length, diameter, diameter of catheter suitable for combined use in an epilepsy diagnosis device placed in blood vessels a step;
Among blood vessels in or near the brain tissue of the subject , based on the wire information, a position or region of a blood vessel to which the device can be placed, and which is suitable for detection of an electrical signal from the first location by the device. an identifying step of identifying the second location;
a display control step of displaying the second location in the blood vessel on a predetermined display unit;
A method of processing information for epilepsy diagnosis, which comprises: a receiving step of receiving designation of a first location, which is a target for detection of electrical signals, in brain tissue of a subject;
Wire information reception for receiving wire information including at least one of intravascular delivery performance, size, expansion force, effective length, diameter, diameter of catheter suitable for combined use in an epilepsy diagnosis device placed in blood vessels a step;
Among blood vessels in or near the brain tissue of the subject , based on the wire information, a position or region of a blood vessel to which the device can be placed, and which is suitable for detection of an electrical signal from the first location by the device. an identifying step of identifying the second location;
a display control step of displaying the second location in the blood vessel on a predetermined display unit;
epilepsy diagnostic computer program for execution by a computer of

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